Landstrom, Jerone Theodore

Landstrom, Jerone Theodore is an individual health care provider with primary practice located at 633 Gov Carlos Camacho Road Suite 104 Guam Medical Plaza, Tamuning GU 96913. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Surgery of the Hand. Allopathic & Osteopathic Physicians / Surgery of the Hand is his primary health care specialty. Landstrom, Jerone Theodore can be contacted via phone (671) 646-4263.

Contact Information

Primary practice address
633 Gov Carlos Camacho Road Suite 104 Guam Medical Plaza Tamuning GU 96913
Phone: (671) 646-4263
Fax: (671) 649-1019
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X M-958 Guam
Allopathic & Osteopathic Physicians / Surgery of the Hand 2086S0105X J9150 Texas
Allopathic & Osteopathic Physicians / Surgery of the Hand 2086S0105X MD9588 Hawaii
Allopathic & Osteopathic Physicians / Surgery of the Hand 2086S0105X M00958 Guam

Profile Details

NPI number 1255407953
LBN Legal business name Landstrom, Jerone Theodore
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 27th, 2006
Last updated Apr 27th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255407953 NPPES
Texas MEDICAID J6266501
Texas Other 0005867019
Texas Other 170804300

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